• FAQs About COVID-19 Testing in SNFs/NFs (8/20)

    Monday, August 10, 2020 | CMS

    Frequently Asked Questions: COVID-19 Testing at Skilled Nursing Facilities/ Nursing Homes includes 27 FAQs:

    1. Who will receive the testing platforms and U.S. Food and Drug Administration (FDA)- authorized antigen diagnostic tests?

    2. How is distribution of the testing platforms and FDA-authorized antigen diagnostic tests being determined? Will these devices be sent directly to the nursing homes or to states for distribution? 

    3. When will the testing platforms and authorized point-of-care tests be distributed?

    4. How many COVID-19 test kits will nursing homes receive?

    5. Who will provide training to nursing home staff? In what format will the training be provided in?

    6. How were nursing homes prioritized to receive a testing platform and FDA-authorized antigen diagnostic tests?

    7. Will HHS be providing more tests after the initial shipment?

    8. What safety precautions are required when performing these tests?

    9. Will every nursing home receive a point-of-care instrument and associated tests? 

    10. Which nursing homes will receive instruments and tests in the first wave of shipments?

    11. When will my nursing home receive the shipment of testing platforms and FDAauthorized antigen diagnostic tests?

    12. How will states be made aware that nursing homes within their states will receive instruments and supplies?

    13. What are antigen tests? Is it required to retest negative results with a PCR test?

    14. How many tests can be conducted with the Quidel Sofia 2 Instrument and the BD Veritor™ Plus System testing platforms?

    15. Why is the federal government sending antigen testing supplies to nursing homes if they cannot be used to rule out SARS-CoV-2 infection and should not be used as the sole basis for treatment?

    16. Are nursing homes required to report results of any COVID-19 tests?

    17. Can nursing homes keep the testing platforms? 

    18. How should facilities handle indeterminate results?

    19. Do facilities need a provider order to conduct the test?

    20. How should the materials be stored when they arrive?

    21. Does a Skilled Nursing Facility/ Nursing Facilities need a CLIA (Clinical Laboratory Improvement Amendments of 1988) Certificate of Waiver in order to perform testing of specimens for COVID-19?

    22. I understand that HHS will be distributing tests and test systems to Skilled Nursing Facilities/ Nursing Facilities. What type of CLIA certificate would my facility need in order to perform this testing?

    23. How do I apply for a CLIA Certificate of Waiver so that my Skilled Nursing Facility/ Nursing Facility can perform COVID-19 testing?

    24. If my Skilled Nursing Facility/ Nursing Facility already holds a CLIA Certificate of Waiver, can we begin performing COVID-19 testing?

    25. If my Skilled Nursing Facility/ Nursing Facility already holds a CLIA Certificate of Waiver, am I required to update my test menu with CMS?

    26. How does my Skilled Nursing Facility/ Nursing Facility obtain the instrument, test kits and disposables?

    27. My Skilled Nursing Facility/ Nursing Facility is located in a CLIA Exempt State (Washington or New York). Will we be able to get one of the new test systems? 

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  • July 28 CDC COVID-19 Call: Diabetes: The Importance of Prevention, Management, and Support

    Monday, July 20, 2020 | CDC

    Coronavirus Disease 2019 (COVID-19) and Diabetes: The Importance of Prevention, Management, and Support

    You may participate in this COCA Call via Zoom

    During this COCA Call, presenters will focus on current information about the impact and increased risk for COVID-19 complications in people with diabetes and the importance of diabetes prevention, management, and support.

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  • CDC Strategies for Optimizing the Supply of PPE and Other Equipment (7/20)

    Wednesday, July 15, 2020 | CDC

    The Centers for Disease Control and Prevention (CDC) offers strategies for optimizing the supply of:

    N95 respirators

    Face masks

    Isolation gowns

    Eye Protection

    Gloves

    Powered Air-Purifying Respirators (PAPRs)

    Elastomeric respirators

    Ventilators

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  • CMS Will Increase Use of QIOs to Fight COVID-19 Hot Spots (7/20)

    Monday, July 13, 2020 | CMS

    The Centers for Medicare & Medicaid Services (CMS) announced the agency’s targeted approach to provide additional resources to nursing homes in coronavirus disease 2019 (COVID-19) hotspot areas.  Specifically, CMS plans to deploy Quality Improvement Organizations (QIOs) across the country to provide immediate assistance to nursing homes in the hotspot areas as identified by the White House Coronavirus Task Force. QIOs are CMS contractors who work with healthcare providers to help them improve the quality of healthcare they provide to Medicare Beneficiaries. In addition, the agency is implementing an enhanced survey process tailored to meet the specific concerns of hotspot areas and will coordinate federal, state and local efforts to leverage all available resources to these facilities. The purpose of these efforts is to target facilities with known infection control issues by providing resources and support that will help them improve quality and safety and protect vulnerable Americans.

    Nursing homes are especially vulnerable to the prevalence and spread of COVID-19.  Additional resources are needed to ensure nursing homes take proactive steps to enhance infection control policies and practices to limit potential transmission and prevent widespread outbreaks within these facilities.

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  • CMS FAQs Detail Recommendations for Allowing Nursing Home Visits (6/20)

    Thursday, June 25, 2020 | CMS

    CMS has issued seven Frequently Asked Questions to supplement existing guidance about the rules for nursing home visitations during the COVID-19 pandemic, starting with No. 1:

    1. What steps should nursing homes take before reopening to visitors? 

    Nursing homes should continue to follow CMS and CDC guidance for preventing the transmission of COVID-19, and follow state and local direction. Because nursing home residents are especially vulnerable, CMS does not recommend reopening facilities to visitors (except for compassionate care situations) until phase three when: 

    • There have been no new, nursing home onset COVID-19 cases in the nursing home for 28 days (through phases one and two) 

    • The nursing home is not experiencing staff shortages 

    • The nursing home has adequate supplies of personal protective equipment and essential cleaning and disinfection supplies to care for residents 

    • The nursing home has adequate access to testing for COVID-19 

    • Referral hospital(s) have bed capacity on wards and intensive care units

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  • CDC Long-term Care COVID-19 Resources Updated (6/20)

    Monday, June 22, 2020 | CDC

    Preparing for COVID-19 in Nursing Homes

    Updated June 25, 2020

    Summary of Changes to the Guidance:

    • Tiered recommendations to address nursing homes in different phases of COVID-19 response
    • Added a recommendation to assign an individual to manage the facility’s infection control program
    • Added guidance about new requirements for nursing homes to report to the National Healthcare Safety Network (NHSN)
    • Added a recommendation to create a plan for testing residents and healthcare personnel for SARS-CoV-2

    Related Pages

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  • COVID-19 NHSN Nursing Home Data Will Be Publicly Reported Weekly (6/20)

    Monday, June 8, 2020 | CMS
    On June 4, 2020, the Centers for Medicare & Medicaid Services (CMS) posted the first set of underlying coronavirus disease 2019 (COVID-19) nursing home data. This data shows that as of May 31, 2020, about 13,600 nursing homes – approximately 88 percent of the 15,400 Medicare and Medicaid nursing homes – had reported the required data to the (CDC). These facilities reported over 95,000 confirmed COVID-19 cases and almost 32,000 deaths. The next set of data will be updated in two weeks.  Going forward after that date, CMS plans to update the data weekly.
    On June 4, 2020, the Centers for Medicare & Medicaid Services (CMS) posted the first set of underlying coronavirus disease 2019 (COVID-19) nursing home data. This data shows that as of May 31, 2020, about 13,600 nursing homes – approximately 88 percent of the 15,400 Medicare and Medicaid nursing homes – had reported the required data to the (CDC). These facilities reported over 95,000 confirmed COVID-19 cases and almost 32,000 deaths. The next set of data will be updated in two weeks.  Going forward after that date, CMS plans to update the data weekly.
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  • COVID-19 Targeted Inspection Results Will Post Monthly (6/20)

    Monday, June 8, 2020 | CMS

    On June 4, 2020, the Centers for Medicare & Medicaid Services (CMS)announced the release of the results from the targeted inspections announced on March 4, 2020, to allow inspectors to focus on the most serious health and safety threats like infectious diseases and abuse during the pandemic. Since March 4, CMS and its network of state-based inspectors have conducted over 8,300 surveys with the results of a total of 5,700 available as of June 4. CMS plans to post the results of the inspections monthly on an ongoing basis as they are completed.

    While the results of health inspections conducted on or after March 4, 2020 will be posted publicly, they will not be used to calculate a nursing home’s health inspection star ratings. Per CMS's April 24, 2020 memorandum, the inspection domain of the Nursing Home Compare website will be held constant temporarily due to the recent prioritization and suspension of certain surveys, to ensure the rating system reflects fair information for consumers.

    Targeted Inspection Results

     

    Memo # QSO 20-33-NH

    Posting Date 2020-06-04

    Fiscal Year 2020

    Summary

    • Nursing Home Inspections: CMS will post health inspection (i.e., surveys) results that were conducted on or after March 4th, 2020, which is the first date that CMS altered the way that inspections are scheduled and conducted. This includes inspections related to complaints and facility-reported incidents (FRIs) that were triaged at the Immediate Jeopardy (IJ) level, and the streamlined Infection Control inspection process that was developed based on the guidance for preventing the spread of COVID-19.

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  • CMS QSO Memo: Enhanced Enforcement Actions Based on Nursing Home COVID-19 Data and Inspection Results (6/20)

    Tuesday, June 2, 2020 | CMS

    The Centers for Medicare & Medicaid Services (CMS) unveiled enhanced enforcement for nursing homes with violations of longstanding infection control practices. The enhanced and targeted accountability measures are based on early trends in the most recent data regarding incidence of COVID-19 in nursing homes, as well as data regarding the results of the agency’s targeted infection control inspections. CMS is increasing enforcement (e.g., civil money penalties (CMPs)) for facilities with persistent infection control violations, and imposing enforcement actions on lower level infection control deficiencies to ensure they are addressed with increased gravity.

    The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) provided additional funding to CMS for necessary survey and certification work related to COVID-19, of which $80 million in new resources will be available for states to increase surveys. To ensure effective oversight is achieved, CMS will allocate the CARES Act funding based on performance-based metrics. States that have not completed 100 percent of focused infection control surveys of their nursing home by July 31, 2020 will be required to submit a corrective action plan to their CMS location outlining the strategy for completion of these surveys within 30 days.  If, after the 30-day period, states have still not performed surveys in 100 percent of nursing homes, their CARES Act fiscal year 2021 allocation may be reduced by 10 percent.  Subsequent 30-day extensions could result in an additional 5 percent reduction. These funds would then be redistributed to those states that completed 100 percent of their focused infection control surveys by July 31.

    Utilizing the CARES Act funding, states will be required to perform on-site surveys of nursing homes with previous COVID-19 outbreaks and will be required to perform on-site surveys (within three to five days of identification) of any nursing home with new COVID-19 suspected and confirmed cases.

    To help nursing homes implement infection control best practices, CMS will provide technical assistance through Quality Improvement Organizations (QIOs). CMS and the Centers for Disease Control and Prevention (CDC) will continue to monitor the data it receives through the new nursing home COVID-19 surveillance system to identify nursing homes with outbreaks and work with Governor’s offices and states to keep nursing home residents safe.

    Since April 19, 2020, CMS has required nursing homes to inform, residents, their families, and representatives of COVID-19 cases in their facilities. For the first time, nursing homes are required to report COVID-19 cases and deaths directly to the CDC on an ongoing basis as the result of an unprecedented CMS regulatory requirement issued on May 1, 2020. The Trump Administration implemented the new reporting requirement to develop a robust federal disease surveillance system to quickly identify problem areas and inform future infection control actions. The reporting requirement applies to long-term care facilities only (also known as skilled nursing facilities and nursing facilities, and generally as nursing homes). By law, CMS regulates and oversees nursing homes, which are certified to provide Medicare and/or Medicaid skilled nursing facility services. Therefore, the data does not include COVID-19 data from assisted living facilities, which are not regulated at the federal level.

    As of May 24, 2020, about 12,500 nursing homes – approximately 80 percent of the 15,400 Medicare and Medicaid nursing homes – had reported the required data to the CDC. These facilities reported over 60,000 confirmed COVID-19 cases and almost 26,000 deaths. Of the nursing homes that reported data, approximately one in four facilities had at least one COVID-19 case, and approximately one in five facilities had at least one COVID-19 related death.  Early analysis shows that facilities with a one-star quality rating were more likely to have large numbers of COVID-19 cases than facilities with a five-star quality rating. CMS will take enforcement action against the nursing homes that have not reported data into the CDC as required under CMS participation requirements.

    CMS will post the underlying CDC-collected data on a link on Nursing Home Compare later this week, so the public can view general information of how COVID-19 has impacted nursing homes in a user-friendly format. The data will be broken down by state, number of residents and number of staff.  The data will be searchable by facility name and will be downloadable so researchers and other stakeholders can perform their own in-depth analysis.  CMS will update the data weekly. CMS will also post a link to the data on the home page of the Nursing Home Compare website so patients, residents, and families can easily find it. Nursing Home Compare is a valuable tool for patients, residents, and families to understand the quality of nursing homes and to support their healthcare decisions. Adding this information only increases its value and reinforces CMS’s commitment to transparency.

    CMS is ratcheting up penalties for noncompliance with infection control to help prevent backsliding, improve accountability, and ensure prompt compliance. Since February 2020 CMS has provided over 13 guidance documents and facts sheets pertaining to infection control and conducted weekly calls with nursing homes to share best practices from the field. The enhanced enforcement actions will increase penalties for nursing homes have had past infection control deficiencies.

    As part of CMS’s response to the COVID-19 pandemic, the agency prioritized the types of nursing home inspections that take place. On March 4, 2020 CMS prioritized inspections to allow inspectors to focus on the most serious health and safety threats like infectious diseases and abuse. On March 23, CMS suspended certain inspections to increase our focus on preventing the spread of COVID-19. Since March 4, CMS and its network of state-based inspectors have conducted over 8,300 surveys with the results of a total of 5,700 available today. There is currently wide variation in the number of focused infection control surveys of nursing homes performed by states, between 11.4 percent and 100 percent, with a national average of approximately 54.1 percent. CMS plans to post the results of the inspections later this week, on a monthly basis as they are completed.

    All of this information are being used to strengthen CMS enforcement action going forward, such that nursing homes are held accountable for resident care. Older Americans are particularly vulnerable to complications arising from the virus and nursing home residents have been uniquely affected. The Trump Administration is intensely focused on protecting this population, but it ultimately falls to the nursing homes themselves to ensure they provide care compliant with essential health and safety requirements.

    CMS is also providing additional support and technical assistance to low performing nursing homes through its QIOs. QIOs are organizations composed of health quality experts and clinicians that have experience in helping healthcare provider to improve the quality of care delivered to people with Medicare. CMS has now charged the QIOs to focus their efforts on providing education and training to all nursing homes in the country.  This will include weekly National Infection Control Training, which focuses on all aspects of infection control, prevention and management to help nursing homes prevent the transmission of COVID-19. 

    QIOs are also providing direct assistance to small and rural nursing homes and those serving vulnerable populations in areas where access to care is limited. The QIOs will help them understand and comply with CMS and CDC reporting requirements and, in some cases, they will provide on-site support to help nursing homes that have been identified as having the greatest needs in infection control. CMS will be working with Governors’ offices to direct QIOs to those nursing homes that have significant needs and have had outbreaks. QIOs will help these facilities create an action plan and implement specific steps to establish a strong infection control and surveillance program.

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  • COVID-19: CMS QSO Memo Details Nursing Home Reopening Recommendations for State and Local Officials (5/20)

    Tuesday, May 19, 2020 | CMS

    • Recommendations for State and Local Officials: CMS is providing recommendations to help determine the level of mitigation needed to prevent the transmission of COVID19 in nursing homes. The recommendations cover the following items:

    o Criteria for relaxing certain restrictions and mitigating the risk of resurgence: Factors to inform decisions for relaxing nursing home restrictions through a phased approach.

    o Visitation and Service Considerations: Considerations allowing visitation and services in each phase.

    o Restoration of Survey Activities: Recommendations for restarting certain surveys in each phase.

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